PERIOPERATIVE METRONIDAZOL-PROPHYLAXIS FOR CESAREAN-SECTION

  • 1 January 1980
    • journal article
    • research article
    • Vol. 184  (6) , 418-423
Abstract
A prospective, randomized clinical trial was conducted in 103 patients undergoing cesarian section to assess the efficacy of prophylactic, i.v. administered metronidazole on the infectious morbidity. A group of 53 patients with perioperative metronidazole prophylaxis was compared to a similar control group without prophylaxis. Bacteriologic swabs were taken from the cervix pre- and postoperatively, using anaerobic transport media. Prophylactic metronidazole reduced postoperative fever of more than 38.degree. C on 2 subsequent days from 60% in the control group to 30,2% in the metronidazole group (P < 0.01), wound infections were reduced from 18% without to 5.7% with prophylaxis (P < 0,05) and endometritis from 30% without to 13,2% with prophylaxis (P < 0,05). An additional antibiotic therapy was necessary in 44% of the cases in the control group compared to 24.5% of the cases in the metronidazole group (P < 0,05). The mean duration of hospitalization was reduced from 12.1 .+-. 3.2 days in the control group to 11.2 .+-. 2.1 in the metronidazole/group (P < 0,01). Anaerobic bacteria were isolated from the servical swabs in 60% preoperatively, with a still increasing incidence to 72% postoperatively, compared to 7% in the metronidazole group. Prophylactic, administered metronidazol reduces the infectious morbidity following cesarian section due to the reduction of the anaerobic flora at the female genital-tract.